Spontaneous Splenic Rupture Five Days after Appendectomy via McBurney Incision: A Case Report

Gabriel Marin, Mario Javier de Miguel Valencia, Ana Ligia Acevedo Ramírez, Miguel Ángel Resano Abárzuza, Maite Millor Muruzabal, Mª Felicidad Pérez Omeñaca and Iñaki Alberdi Ibáñez

Department of General Surgery, Reina Sofía Hospital, Tudela, Navarra, Spain
Department of Pathology, Reina Sofía Hospital, Tudela, Navarra, Spain
Department of Radiology, Reina Sofía Hospital, Tudela, Navarra, Spain

^*Correspondance to: Gabriel Marin 

 PDF  Full Text DOI: 10.25107/2474-1647.2571

Abstract

Introduction: Spontaneous splenic rupture is an unusual and life-threatening surgical emergency. The literature on this previously debated entity consists mainly of clinical cases. We present the first case of a splenic rupture occurred after an appendectomy via McBurney incision. Clinical Case: A 10 year-old patient with a clinical picture of hypogastric pain and vomiting of 48 hours onset. She was diagnosed with appendicular peritonitis and appendectomy with peritoneal lavage was performed through a McBurney incision. Five days after hospital discharge, the patient was re-admitted due to left flank pain and pallor. The patient was re-intervened through the McBurney incision, revising the surgical bed of the appendectomy. Postoperatively Angio-CT was performed for suspicion of persisting bleeding. A ruptured splenic hematoma with active signs of bleeding was found. Urgent midline laparotomy and splenectomy was performed. Conclusion: Delayed splenic rupture after appendectomy is an unexpected event. The presence of hemoperitoneum post appendectomy may prematurely lead to intraoperative reexploration of the surgical site. Preoperative efforts to accurately diagnose the bleeding source may avoid multiple surgeries and shorten hospital stay.

Keywords

Appendectomy; Complications; Spontaneous rupture; Rupture; Spleen; Atraumatic

Cite the article

Marin G, de Miguel Valencia MJ, Acevedo Ramírez AL, Resano Abárzuza MÁ, Muruzabal MM, Felicidad Pérez Omeñaca Mª, et al. Spontaneous Splenic Rupture Five Days after Appendectomy via McBurney Incision: A Case Report. Clin Surg. 2019; 4: 2571.